<form id="add-form" class="form-horizontal" role="form" data-toggle="validator" method="POST" action="">

    <div class="form-group">
        <label class="control-label col-xs-12 col-sm-2">{:__('User_id')}:</label>
        <div class="col-xs-12 col-sm-8">
            <input id="c-user_id" data-rule="" data-source="user/user/index" data-field="nickname" class="form-control selectpage" name="row[user_id]" type="text" value="">
        </div>
    </div>
     <div class="form-group">
        <label class="control-label col-xs-12 col-sm-2">{:__('Platform')}:</label>
        <div class="col-xs-12 col-sm-8">
            <select  id="c-platform" data-rule="required" class="form-control selectpicker" name="row[platform]">
                {foreach name="platformList" item="vo"}
                    <option value="{$key}" {in name="key" value="1"}selected{/in}>{$vo}</option>
                {/foreach}
            </select> 
        </div>
    </div>
     <div class="form-group"  id="c-name-c">
        <label class="control-label col-xs-12 col-sm-2">{:__('Name')}:</label>
        <div class="col-xs-12 col-sm-8">
            <input id="c-name" data-rule="" class="form-control" name="row[name]" type="text" value="">
        </div>
    </div>
    <div class="form-group"  id="c-staffnumber-c">
        <label class="control-label col-xs-12 col-sm-2">{:__('Staffnumber')}:</label>
        <div class="col-xs-12 col-sm-8">
            <input id="c-staffnumber" data-rule="" class="form-control" name="row[staffnumber]" type="text" value="">
        </div>
    </div>
    <div class="form-group" >
        <label class="control-label col-xs-12 col-sm-2">客人姓名:</label>
        <div class="col-xs-12 col-sm-8">
            <input id="c-username" data-rule="" class="form-control" name="row[username]" type="text" value="">
        </div>
    </div>
    <div class="form-group" >
        <label class="control-label col-xs-12 col-sm-2">客人电话:</label>
        <div class="col-xs-12 col-sm-8">
            <input id="c-phonenumber" data-rule="" class="form-control" name="row[phonenumber]" type="text" value="">
        </div>
    </div>
    <div class="form-group" id="c-unionid-c"  style="display:none">
        <label class="control-label col-xs-12 col-sm-2">{:__('Unionid')}:</label>
        <div class="col-xs-12 col-sm-8">
            <input id="c-unionid" data-rule=""  data-source="coupons/coupons/indexThird" data-field="openname" class="form-control selectpage"  class="form-control" name="row[unionid]" type="text" value="">
        </div>
    </div>
    <div class="form-group">
        <label class="control-label col-xs-12 col-sm-2">{:__('Coupon_category_id')}:</label>
        <div class="col-xs-12 col-sm-8">
            <input id="c-coupon_category_id" data-rule="required" data-source="coupons/category/index" data-field='nametext' class="form-control selectpage" name="row[coupon_category_id]" type="text" value="">
        </div>
    </div>
    <div class="form-group">
        <label class="control-label col-xs-12 col-sm-2">{:__('Begintime')}:</label>
        <div class="col-xs-12 col-sm-8">
            <input id="c-begintime" data-rule="" class="form-control datetimepicker" data-date-format="YYYY-MM-DD HH:mm:ss" data-use-current="true" name="row[begintime]" type="text" value="{:date('Y-m-d H:i')}">
        </div>
    </div>
    <div class="form-group">
        <label class="control-label col-xs-12 col-sm-2">{:__('Endtime')}:</label>
        <div class="col-xs-12 col-sm-8">
            <input id="c-endtime" data-rule="" disabled="disabled" class="form-control datetimepicker" data-date-format="YYYY-MM-DD HH:mm:ss" data-use-current="true" name="row[endtime]" type="text" value="" placeholder="结束时间根据优惠券类型自动生成结束时间">
        </div>
    </div>
    <div class="form-group">
        <label class="control-label col-xs-12 col-sm-2">{:__('Clinic_id')}:</label>
        <div class="col-xs-12 col-sm-8">
            <input id="c-clinic_id" data-rule="" data-source="coupons/clinic/index" class="form-control selectpage" name="row[clinic_id]" type="text" value="">
        </div>
    </div>
    <div class="form-group">
        <label class="control-label col-xs-12 col-sm-2">{:__('Statusdata')}:</label>
        <div class="col-xs-12 col-sm-8">
            <div class="radio">
            {foreach name="statusdataList" item="vo"}
            <label for="row[statusdata]-{$key}"><input id="row[statusdata]-{$key}" name="row[statusdata]" type="radio" value="{$key}" {in name="key" value="0"}checked{/in} /> {$vo}</label> 
            {/foreach}
            </div>

        </div>
    </div>
    <div class="form-group">
        <label class="control-label col-xs-12 col-sm-2">{:__('Number')}:</label>
        <div class="col-xs-12 col-sm-8">
            <input id="c-number" disabled="disabled" placeholder="系统自动生成唯一编码" class="form-control" name="row[number]" type="text" value="">
        </div>
    </div>
    <div class="form-group">
        <label class="control-label col-xs-12 col-sm-2">{:__('Qrcodeimage')}:</label>
        <div class="col-xs-12 col-sm-8">
                <input id="c-qrcodeimage" disabled="disabled" placeholder="系统自动生成优惠券小程序码" class="form-control" name="row[qrcodeimage]" type="text" value="">

        </div>
    </div>
   
    <div class="form-group">
        <label class="control-label col-xs-12 col-sm-2">财务订单号:</label>
        <div class="col-xs-12 col-sm-8">
            <input id="c-sn" data-rule="" class="form-control" name="row[finance_sn]" type="text" value="">
        </div>
    </div>
    <div class="form-group layer-footer">
        <label class="control-label col-xs-12 col-sm-2"></label>
        <div class="col-xs-12 col-sm-8">
            <button type="submit" class="btn btn-success btn-embossed disabled">{:__('OK')}</button>
            <button type="reset" class="btn btn-default btn-embossed">{:__('Reset')}</button>
        </div>
    </div>
</form>